OVERVIEW
Those involved in bodybuilding at an amateur or professional level are familiar with this particular injury: a disruption in the biceps brachii muscle is considered to be a common injury in this class of sports-practicing population, especially in the age group between 20-40 years. The reason why the detachment of the tendon from the biceps brachii “prefers” these specific athletes is in the uneven contraction of the muscle during exercise with free weights when the elbow extends. The part which the disruption is found in (namely, the discontinuation of the tendon) is the distal one, where a high load is applied.
The vulnerability of of the biceps brachii lies in the fact that, although it arises from the scapula with two thin origin tendons (long and short head), it is distally attached to the radius with only one strong tendon insertion. And, while one of the insertion tendons is injured the muscle remains active, the same does not apply if there is an injury to the origin tendon, which is unique.

WHICH ARE THE SYMPTOMS?
Many patients report that, during the disruption, they heard a distinctive sound, followed by pain – in general the dominant arm is considered to be more vulnerable. Classical symptoms are also swelling and ecchymosis in the affected area and an inability of a pronation and supination of the forearm. It is very probable, however, that a deformation known as the “Popeye phenomenon” is also found, as the muscle is rounded and thickened over the elbow, reminding the popular cartoon hero.

WHICH IS THE BEST TREATMENT?
Magnetic resonance imaging will show the extent of the lesion to the orthopaedist, if it is a partial or total disruption, as the surgical approach shall depend on it. Treatment is basically surgical because the torn tendon should be repaired with special screws which include sutures, and then it shall be transfixed onto its anatomical position, in order to prevent the biceps brachii from losing its functionality. The incision is small and is made at the height of the anterior surface of the elbow. Postoperatively, the rehabilitation period is over 2 months and includes physiotherapy and strengthening exercises.

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